Traditional Chinese medicine manipulative reduction combined with percutaneous vertebroplasty for treating type Ⅲ Kummell's disease: A case report

BACKGROUND A patient with type Ⅲ Kummell’s disease had a ruptured posterior cortex of the fractured vertebral body, which caused spinal cord compression. An open surgery was considered the best choice of operation. However, the patient and her family refused open surgery and instead demanded a minimally invasive surgical treatment such as percutaneous vertebroplasty(PVP). After preoperative discussion, we finally adopted the novel therapy of traditional Chinese medicine manipulative reduction(TCMMR) combined with PVP.CASE SUMMARY A patient with type Ⅲ Kummell’s disease exhibiting bone block-induced spinal cord compression was admitted to our hospital. She suffered from a variety of medical disorders but refused open surgery, and instead asked for PVP surgery. TCMMR, in parallel with PVP, was used to restore the height of the compressed vertebral body and reduce the symptoms of spinal cord compression by the bone block in order to strengthen the vertebral body and prevent further collapse. The surgery was very successful. The height of the compressed vertebra was restored, and the symptom of spinal cord compression by bone block was reduced successfully via TCMMR. The fractured vertebra was solidified by the PVP. The pain visual analog score declined from preoperative 7 scores to postoperative 2 scores, and the Frankel spinal cord scale increased from preoperative D degree to postoperative E degree.CONCLUSION The new method has advantages in treating patients with type Ⅲ Kummell’s disease who cannot be treated with open surgery.

Reduction in nerve root compression by the nucleus pulposus after Feng's Spinal Manipulation

Ninety-four patients with lumbar intervertebral disc herniation were enrolled in this study. Of these, 48 were treated with Feng＇s Spinal Manipulation, hot fomentation, and bed rest （treatment group）. The remaining 46 patients were treated with hot fomentation and bed rest only （control group）. After 3 weeks of treatment, clinical parameters including the angle of straight-leg raising, visual analogue scale pain score, and Japanese Orthopaedic Association score for low back pain were improved. The treatment group had significantly better improvement in scores than the control group. Magnetic resonance myelography three-dimensional reconstruction imaging of the vertebral canal demonstrated that filling of the compressed nerve root sleeve with cerebrospinal fluid increased significantly in the treatment group. The diameter of the nerve root sleeve was significantly larger in the treatment group than in the control group. However, the sagittal diameter index of the herniated nucleus pulposus and the angle between the nerve root sleeve and the thecal sac did not change significantly in either the treatment or control groups. The effectiveness of Feng＇s Spinal Manipulation for the treatment of symptoms associated with lumbar intervertebral disc herniation may be attributable to the relief of nerve root compression, without affecting the herniated nucleus pulposus or changing the morphology or position of the nerve root.

Design of an Acoustic Levitator for Three-Dimensional Manipulation of Numerous Particles

We present a design of an acoustic levitator consisting of three pairs of opposite transducer arrays.Three orthogonal standing waves create a large number of acoustic traps at which the particles are levitated in mid-air.By changing the phase difference of transducer arrays,three-dimensional manipulation of particles is successfully realized.Moreover,the relationship between the translation of particles and the phase difference is experimentally investigated,and the result is in agreement with the theoretical calculation.This design can expand the application of acoustic levitation in many fields,such as biomedicine,ultrasonic motor and new materials processing.

CO_(2) Reduction on Metal-Doped SnO_(2)(110)Surface Catalysts:Manipulating the Product by Changing the Ratio of Sn:O

The electrocatalytic carbon dioxide reduction reaction(CO_(2) RR)producing HCOOH and CO is one of the most promising approaches for storing renewable electricity as chemical energy in fuels.SnO_(2) is a good catalyst for CO_(2)-to-HCOOH or CO_(2)-to-CO conversion,with different crystal planes participating the catalytic process.Among them,(110)surface SnO_(2) is very stable and easy to synthesisze.By changing the ratio of Sn:O for SnO_(2)(110),we have two typical SnO_(2) thin films:fully oxidized(stoichiometric)and partially reduced.In this work,we are concerned with different metals(Fe,Co,Ni,Cu,Ru,Rh,Pd,Ag,Os,Ir,Pt,and Au)-doped SnO_(2)(110)with different activity and selectivity for CO_(2) RR.All these changes are manipulated by adjusting the ratio of Sn:O in(110)surface.The results show that stochiometric and reduced Cu/Ag doped SnO_(2)(110)have different selectivity for CO_(2) RR.More specifically,stochiometric Cu/Ag-doped SnO_(2)(110)tends to generate CO(g).Meanwhile,the reduced surface tends to generate HCOOH(g).Moreover,we also considered the competitive hydrogen evolution reaction(HER).The catalysts SnO_(2)(110)doped by Ru,Rh,Pd,Os,Ir,and Pt have high activity for HER,and others are good catalysts for CO_(2) RR.

Surface manipulation of a triple-conducting cathode for protonic ceramic fuel cells to enhance oxygen reduction activity and CO_(2) tolerance

One of the main obstacles limiting the performance of protonic ceramic fuel cells(PCFCs) is the sluggish kinetics of the oxygen reduction reaction(ORR) at reduced temperatures.Here,the surface manipulation of a triple-conducting cathode BaCe_(0.5)Pr_(0.3)Y_(0.2)O_(3-δ)(BCPY) by an efficient catalyst coating PrNi_(0.5)Co_(0.5)O_(3-δ)(PNC) to enhance the ORR activity and CO_(2) tolerance is reported.The developed PNC-coated BCPY cathode achieves the polarization resistance of 0.25 and 1.00 Ω cm^(2) at 600 and 500 ℃,respectively,approximately 1/5 of that for the pristine BCPY cathode(0.99 and 4.79 Ω cm^(2)),while maintaining an excellent CO_(2) tolerance.The single cell on a BaZr_(0.8)Yb_(0.2)O_(3-δ) electrolyte also exhibits a high peak power density of 0.79 W cm^(-2)at 700 ℃ and a stable operation for 200 h at 600 ℃.Such high ORR activity is mainly attributed to the synergistic effect of BCPY support and PNC nanoparticles.Namely,BCPY provides a tripleconducting path(mainly protons),and PNC nanoparticles facilitates surface oxygen exchange and steam adsorption/desorption processes due to the enriched surface oxygen vacancies.This study will provide a new design strategy for developing high-performance PCFCs cathode.

Simulation analysis on three-dimensional slope failure under different conditions

The failure mechanism of two-dimensional（2D） and three-dimensional（3D） slopes were investigated by using the strength reduction method.An extensive study of 3D effect was conducted with respect to boundary conditions,shear strength and concentrated surcharge load.The results obtained by 2D and 3D analyses were compared and the applicable scope of 2D and 3D method was analyzed.The results of the numerical simulation show that 3D effect is sensitive to the width of slip surface.As for slopes with specific geometry,3D effect is influenced by dimensionless parameter c/（γHtanφ）.For those infinite slopes with local loading,external load has the major impact on failure mode.For those slopes with local loading and geometric constraints,the failure mode is influenced by both factors.With the increase of loading length,boundary condition exerts a more significant impact on the failure mode,and then 2D and 3D stability charts are developed,which provides a rapid and reliable way to calculate 2D and 3D factor of safety without iteration.Finally,a simple and practical calculation procedure based on the study of 3D effect and stability charts is proposed to recognize the right time to apply 2D or 3D method.

Incremental Linear Discriminant Analysis Dimensionality Reduction and 3D Dynamic Hierarchical Clustering WSNs

Optimizing the sensor energy is one of the most important concern in Three-Dimensional(3D)Wireless Sensor Networks(WSNs).An improved dynamic hierarchical clustering has been used in previous works that computes optimum clusters count and thus,the total consumption of energy is optimal.However,the computational complexity will be increased due to data dimension,and this leads to increase in delay in network data transmission and reception.For solving the above-mentioned issues,an efficient dimensionality reduction model based on Incremental Linear Discriminant Analysis(ILDA)is proposed for 3D hierarchical clustering WSNs.The major objective of the proposed work is to design an efficient dimensionality reduction and energy efficient clustering algorithm in 3D hierarchical clustering WSNs.This ILDA approach consists of four major steps such as data dimension reduction,distance similarity index introduction,double cluster head technique and node dormancy approach.This protocol differs from normal hierarchical routing protocols in formulating the Cluster Head(CH)selection technique.According to node’s position and residual energy,optimal cluster-head function is generated,and every CH is elected by this formulation.For a 3D spherical structure,under the same network condition,the performance of the proposed ILDA with Improved Dynamic Hierarchical Clustering(IDHC)is compared with Distributed Energy-Efficient Clustering(DEEC),Hybrid Energy Efficient Distributed(HEED)and Stable Election Protocol(SEP)techniques.It is observed that the proposed ILDA based IDHC approach provides better results with respect to Throughput,network residual energy,network lifetime and first node death round.

Three-dimensional （3D） interconnected networks fabricated via in-situ growth of N-doped graphene/ carbon nanotubes on Co-containing carbon nanofibers for enhanced oxygen reduction

The strategy of combining highly conductive frameworks with abundant active sites is desirable in the preparation of alternative catalysts to commercial Pt/C for the oxygen reduction reaction （ORR）. In this study, N-doped graphene （NG） and carbon nanotubes （CNT） were grown in-situ on Co-containing carbon nanofibers （CNF） to form three-dimensional （3D） interconnected networks. The NG and CNT bound the interlaced CNF together, facilitating electron transfer and providing additional active sites. The 3D interconnected fiber networks exhibited excellent ORR catalytic behavior with an onset potential of 0.924 V （vs. reversible hydrogen electrode） and a higher current density than Pt/C beyond 0.720 V. In addition, the hybrid system exhibited superior stability and methanol tolerance to Pt/C in alkaline media. This method can be extended to the design of other 3D interconnected network architectures for energy storage and conversion applications.

Posterior Reduction and Monosegmental Fusion with Intraoperative Three-dimensional Navigation System in the Treatment of High-grade Developmental Spondylolisthesis

Background： The treatment of high-grade developmental spondylolisthesis （HGDS） is still challenging and controversial. In this study, we investigated the efficacy of the posterior reduction and monosegmental fusion assisted by intraoperative three-dimensional （3D） navigation system in managing the HGDS. Methods： Thirteen consecutive HGDS patients were treated with posterior decompression, reduction and monosegmental fusion ofL5/S1, assisted by intraoperative 3D navigation system. The clinical and radiographic outcomes were evaluated, with a minimum follow-up of 2 years. The differences between the pre- and post-operative measures were statistically analyzed using a two-tailed, paired t-test. Results： At most recent follow-up, 12 patients were pain-free. Only l patient had moderate pain, There were no permanent neurological complications or pseudarthrosis. The magnetic resonance imaging showed that there was no obvious disc degeneration in the adjacent segment. All radiographic parameters were improved. Mean slippage improved from 63.2% before surgery to 12.2% after surgery and 11.0% at latest follow-up. Lumbar lordosis changed from preoperative 34.9 ± 13.3° to postoperative 50.4 ±9.9°, and 49.3 ± 7.8° at last follow-up. L5 incidence improved from 71.0 ± 11.3° to 54.0 ± 1 1.9° and did not change significantly at the last follow-up 53.±1 15.4°. While pelvic incidence remained unchanged, sacral slip significantly decreased from preoperative 32.7± 12.5° to postoperative 42.6 ± 9.8°and remained constant to the last follow-up 44.4 ± 6.9°. Pelvic tilt significantly decreased from 38.4±12.5° to 30.9± 8.1° and remained unchanged at the last fbllow-up 28.1± 11.2°. Conclusions： Posterior reduction and monosegmental fusion of L5/S1 assisted by intraoperative 3D navigation are an effective technique for managing high-grade dysplastic spondylolisthesis. A complete reduction of local deformity and excellent correction of overall sagittal balance can be achieved.

Three-dimensional printing combined with open reduction and internal fixation versus open reduction and internal fixation in the treatment of acetabular fractures:A systematic review and meta-analysis

Purpose:This meta-analysis compared the clinical outcome of three-dimensional(3D)printing combined with open reduction and internal fixation(ORIF)to traditional ORIF in the treatment of acetabular fractures.Methods:We searched the Cochrane Library,PubMed,Embase,VIP database,CNKI,and Wanfang data-base with keywords"acetabular fracture","3D printing","three-dimensional printing","open reduction and internal fixation","Acetabulum","Acetabula"from January 2000 to March 2020.Two reviewers independently selected articles,extracted data,assessed the quality evidence and risk bias of included trials using the Cochrane Collaboration’s tools and/or Newcastle-Ottawa scale.When the two analysts had different opinions,they would ask the third analyst for opinion.Randomized controlled trials or retrospective comparative studies of 3D printing combined with ORIF(3D printing group)versus traditional ORIF(conventional group)in the treatment of acetabular fractures were selected.The data of operation time,intraoperative blood loss,intraoperative fluoroscopy times,incidence of complications,excellent and good rate of Matta score for reduction,and excellent and good rate of hip function score were extracted.Stata14.0 statistical software was used for data analysis.Results:Altogether 9 articles were selected,including 5 randomized controlled trials and 4 retrospective studies.A total of 467 patients were analyzed,250 in the conventional group,and 217 in the 3D printing group.The operation time in the 3D printing group was less than that in the conventional group and the difference was statistically significant(standardized mean difference(SMD)=-1.19,95%CI:-1.55 to-0.82,p<0.05).The intraoperative bleeding volume of the 3D printing group was significantly lower than that of the conventional group(SMD=-1.08,95%CI:-1.65 to-0.51,p<0.05).The fluoroscopy times were less in the 3D printing group than in the conventional group and the difference was statistically significant(SMD=-1.64,95%CI:-2.35 to-0.93,p<0.05).The total incidence of complications in the 3D printing group was significantly lower than that in the conventional group(OR=0.43,95%CI:0.24-0.79,p<0.05).There was no significant difference in the excellent and good rate of Matta score for reduction between the two groups(OR=0.60,95%CI:0.34-1.06,p>0.05).There was no significant difference in the excellent and good rate of hip function score at the end of postoperative follow-up between the two groups(OR=0.84,95%CI:0.46-1.56,p>0.05),but the follow-up time varies from 6 months to 40 months.Conclusion:Compared with traditional ORIF,3D printing combined with ORIF has certain advantages in terms that 3D printing not only helps surgeons to understand acetabular fractures more intuitively,but also effectively reduces operation time,intraoperative blood loss,intraoperative fluoroscopy times,and postoperative complications.However,there were no significant differences in the excellent and good rate of Matta score for reduction and the excellent and good rate of hip function score at the end of follow-up.

Implementation of natural hand gestures in holograms for 3D object manipulation

Holograms provide a characteristic manner to display and convey information, and have been improved to provide better user interactions Holographic interactions are important as they improve user interactions with virtual objects. Gesture interaction is a recent research topic, as it allows users to use their bare hands to directly interact with the hologram. However, it remains unclear whether real hand gestures are well suited for hologram applications. Therefore, we discuss the development process and implementation of three-dimensional object manipulation using natural hand gestures in a hologram. We describe the design and development process for hologram applications and its integration with real hand gesture interactions as initial findings. Experimental results from Nasa TLX form are discussed. Based on the findings, we actualize the user interactions in the hologram.

多连杆刚柔机械手设计与手指减振分析

针对陶瓷易碎零件分拣过程中难以稳定抓取的问题,设计了一种能够有效稳定抓取的新型多连杆刚柔机械手。首先,以机械传动为基础,将刚性关节与柔性材料相结合,设计机械手的传动方式与柔顺关节的最优结构,并在三维软件上构建刚柔机械手的整体结构;其次,通过对机械手手指结构进行简化,采用拉格朗日理论和有限元离散方法,构建出具有尖端质量的手指多连杆刚柔耦合动力学模型;最后,求解出机械手手指在运动过程中的动力学方程。在此基础上,通过设计减振方案,对机械手手指结构做出优化和改进。仿真实验结果表明:在外激力为2 N的条件下,改进结构后的刚柔机械手手指其振动的幅度降低8 mm,且恢复稳定的时间缩短了4 s以上,在一定程度上提高了分拣和抓取过程中的抗冲击力,保证了对陶瓷易碎零件抓取过程的稳定性。

手法复位对骨质疏松性椎体压缩骨折椎体成形术后疼痛及脊柱功能的影响及安全性评价

目的:应用系统评价的方法对手法复位联合经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性椎体压缩骨折的疗效及安全性进行分析,为临床提供研究证据。方法:通过计算机系统检索在2024年3月之前公开发表在PubMed、Cochrane图书馆数据库、EMBASE数据库、SinoMed文献服务系统、CNKI数据库、万方数据库、中国科技期刊数据库中有关手法复位联合PVP治疗骨质疏松性椎体压缩骨折的随机对照研究。由2位研究人员对文献进行独立筛选和数据提取,并参照Cochrane协作网标准,对纳入的随机对照试验逐一进行质量评价,对符合纳入标准的相关研究采用RevMan 5.4.1软件进行Meta分析。结果:最终共纳入18篇随机对照试验,共1702例患者,其中手法复位联合PVP组857例,PVP组845例。Meta分析结果显示:手法复位联合PVP与单纯PVP组相比较,近期视觉模拟量表(visual analogue scale,VAS)评分[均数差值(mean difference,MD)=-0.57,95%置信区间(confidence interval,CI):-1.07~-0.07,P=0.03)、远期VAS评分(MD=-0.78,95%CI:-1.09~0.47,P<0.00001)、近期Oswestry功能障碍指数(the oswestry disability index,ODI)评分(MD=-3.99,95%CI:-4.91~-3.07,P<0.00001)、远期ODI评分(MD=-7.02,95%CI:-7.99~-6.05,P<0.00001)、椎体后凸Cobb角(Cobb′s angle,Cobb)(MD=-6.07,95%CI:-8.10~-4.03,P<0.00001)、骨水泥渗漏发生率[比值比(odds ratio,OR)=0.33,95%CI:0.17~0.67,P=0.002)等诸多方面均有显著性差异(P<0.05)。结论:手法复位联合PVP在改善骨质疏松性椎体压缩骨折患者术后疼痛、脊柱功能方面具有显著优势,安全性较好。

补阳还五汤联合脊柱定点旋转复位手法干预颈型颈椎病的临床研究

目的 探讨补阳还五汤联合脊柱定点旋转复位手法对颈型颈椎病患者颈椎生理曲度及炎症因子水平的影响。方法 选取2021年2月-2023年2月收治的100例颈型颈椎病患者,随机分成2组。对照组采用牵引方法治疗,观察组在对照组治疗基础上联合补阳还五汤联合脊柱定点旋转复位手法治疗,均连续治疗4周。观察2组患者治疗前后中医证候积分、颈椎功能障碍(NDI)评分、视觉模拟(VAS)评分、颈椎生理曲度、颈椎各方向ROM、炎性因子指标改善情况,比较2组总有效率和治疗安全性。结果 治疗后,2组各项中医证候积分、NDI评分、VAS评分、各项炎性因子指标均降低,且观察组较对照组低(P<0.05);2组颈椎生理曲度及颈椎各方向ROM均升高,且观察组较对照组高(P<0.05);观察组总有效率(92.0%)高于对照组(76.0%)(P<0.05);2组均未发生治疗相关不良反应。结论 补阳还五汤联合脊柱定点旋转复位手法能够缓解颈型颈椎病临床症状,抑制患者体内炎症反应,改善颈椎生理曲度,提高颈椎活动功能,疗效明确,安全性良好。

手法复位小夹板外固定结合红白舒筋散治疗桡骨远端骨折的临床观察

目的 探讨手法复位小夹板外固定结合红白舒筋散治疗桡骨远端骨折的临床疗效。方法 选取2021年1月-2022年6月本院收治的80例桡骨远端骨折患者,按照随机数表法分为观察组与对照组,各40例。对照组以手法复位小夹板外固定治疗,观察组在对照组治疗基础上增加红白舒筋散外敷治疗。连续治疗1个月后评估2组的症状消退时间、骨折愈合时间、腕关节活动度、治疗安全性。结果 观察组症状包括疼痛、肿胀、畸形、瘀血消退、骨折愈合时间均短于对照组(P<0.05)。观察组腕关节活动度均高于对照组(P<0.05)。观察组满意度高于对照组(P<0.05)。2组不良反应发生率无统计学意义(P>0.05)。结论 红白舒筋散外敷结合手法复位小夹板外固定治疗桡骨远端骨折的效果良好,可促进患者症状消退,缩短骨折愈合时间,改善患者的腕关节活动度,降低炎症因子水平,改善血液流变学指标,治疗安全性良好。

基于“筋、节、骨、髓”分型探讨神经根型颈椎病的手法治疗

神经根型颈椎病(CSR)是一种由于颈椎间盘和椎间关节退变引起的疾病,主要表现为颈部、肩部及上肢神经支配区域的疼痛、感觉异常和运动障碍。传统中医的筋骨辨证在治疗该病时存在概念不清、辨证分型不一等问题。岐黄学者林定坤教授在筋骨辨证的基础上,结合现代解剖学提出了颈椎“筋”“节”“骨”“髓”4大分型。该文通过总结林定坤教授对CSR筋骨辨证学术思想,总结手法治疗该病的作用靶点,提出基于筋劳、节错、骨变和髓损等4种病损分型,采用理筋、调节、护髓和治骨4种手法治疗,以期完善骨伤科手法治疗CSR的辨证施治体系,为临床提供参考。

颈椎矢状位端提手法对椎间盘及小关节影响的有限元分析

背景:在颈椎病的致病因素中,椎间盘突出、小关节错位和椎间孔狭窄是导致患者出现症状的重要因素,而不适当的手法复位可能会加重颈椎间盘破裂的可能性,导致患者症状加重。目的:通过有限元分析比较传统颈椎旋转复位手法与颈椎矢状位端提手法对施术节段椎间盘、小关节和椎间孔面积的影响。方法:选取1名颈部正常男性志愿者的颈部CT资料,将CT数据导入Mimics 17.0三维重建软件,依次使用Geo-magic Studio 12.0、Solidworks2017和Ansys Workbench 17.0软件构建椎间盘、关节软骨等C_(3-6)颈椎有限元模型;固定C_(5)椎体下终板,在上位椎体(C_3)的上表面施加均匀分布、垂直向下的50 N载荷,比较实施传统颈椎旋转复位手法与颈椎矢状位端提手法和整复时,C_(4)-C_(5)节段椎间盘应力、形变大小及方向、关节囊应力、小关节位移及双侧椎间孔面积的变化。结果与结论:(1)实施旋转复位手法时,C_(4-5)椎间盘的最大范式等效应力为8.06 MPa、总形变为1.05 mm,纤维环向左前外膨出;实施矢状位端提手法时,C_(4-5)椎间盘的最大范式等效应力为2.60 MPa、总形变为0.90 mm,纤维环向左后方膨出;相比于旋转复位手法,矢状位端提手法在施术时对椎间盘的压力较小(约为颈椎旋转手法的32.3%)、椎间盘形变程度也轻(约为旋转手法的85.7%);(2)实施旋转复位手法时,左侧和右侧关节囊韧带最大应力分别为0.37 MPa和1.69 MPa,小关节的总体位移为2.21 mm,右侧椎间孔面积减小约3.8%,左侧椎间孔面积增大约0.9%;实施矢状位端提手法时,左侧和右侧关节囊韧带最大应力分别为0.27 MPa和1.70 MPa,小关节的总体位移为1.63 mm,右侧椎间孔面积增大约2.6%,左侧椎间孔面积减小约0.9%;与旋转复位手法相比,矢状位端提手法对小关节的位移、关节囊应力和椎间孔面积改变较小,操作时较为安全;(3)结果提示,与颈椎旋转复位手法相比,矢状位端提手法对小关节位移、椎间盘应力/形变程度、关节囊应力和椎间孔面积的改变较小,临床中在准确评估患者病情后应结合生物力学结果选择更为合适的手法。

手法复位联合咬合板治疗颞下颌关节盘不可复性前移位疼痛与最大张口度的Meta分析

目的:通过Meta分析,比较手法复位联合咬合板治疗颞下颌关节盘不可复性前移位患者疼痛与最大张口度疗效是否优于仅进行手法或仅进行咬合板治疗。方法:计算机检索Web of Science、PubMed、Cochrane Library、维普(VIP)、中国知网(CNKI)、万方中手法复位联合咬合板治疗颞下颌关节盘不可复性前移位的随机对照试验(RCTs)文献,并参考Cochrane手册评估文献质量,运用RevMan5.4软件分析结局指标。结果:本研究纳入6个RCTs,患者共计393例。Meta分析结果显示,对于颞下颌关节盘不可复性前移位患者,观察组进行手法复位联合咬合板治疗,在降低疼痛评分[SMD=-0.34,95%CI(-0.54,-0.13),P=0.001]与改善最大张口度[SMD=0.51,95%CI(0.31,0.71),P<0.00001]方面疗效均比对照组较优,差异具有统计学意义(P<0.05)。结论:手法复位联合咬合板治疗改善颞下颌关节盘不可复性前移位患者疼痛和最大张口度疗效优于单独使用手法复位或单独佩戴咬合板。

疏筋整复手法治疗寰枢关节紊乱症的力学量化研究

目的:探讨疏筋整复手法治疗寰枢关节紊乱症生物力学参数的量效关系。方法:自2022年10月至2023年5月收治寰枢关节紊乱症患者18例,其中男10例,女8例;年龄24~27(25.50±1.10)岁;颈椎CT示齿状突右侧偏歪16例,左侧偏歪2例。采用穿戴式按摩手法测量手套测量疏筋整复手法治疗寰枢关节紊乱症的力学参数,量化疏筋时力的大小、频率及力学曲线图和整复时启动力、扳动力、扳动时间及力学曲线图,比较患侧和对侧手法操作的差异性。结果:疏筋手法实施中风池穴部位患侧最大作用力、频率为(19.82±2.02)N、(116.83±14.49)次/分,对侧分别为(13.87±2.19)N、(188.89±16.03)次/分;两侧最大作用力、频率比较,差异有统计学意义(P<0.05)。缺盆穴患侧最大作用力、频率为(14.44±3.27)N、(139.06±28.47)次/分,对侧为(9.41±1.38)N、(142.50±28.47)次/分;两侧最大作用力比较,差异有统计学意义(P<0.05)。整复手法实施中患侧启动力、扳动力、扳动时间分别为(14.16±5.98)N、(11.56±6.63)N、(0.14±0.03)s,对侧分别为(8.94±3.39)N、(8.30±4.64)N、(0.18±0.04)s;两侧启动力、扳动力、扳动时间比较,差异有统计学意义(P<0.05)。结论:疏筋整复手法针对患侧施以轻巧的疏筋力即可恢复颈椎间的力学平衡,加强寰枢关节紊乱的恢复趋势,在此基础上再施以轻巧的旋扳力便能够使得寰枢椎齿状突回位,体现了手法安全性高的特点。

调控N中间体与一维共轭配位聚合物的相互作用促进电催化硝酸盐还原产氨

随着工农业的快速发展及城市化进程的加速,含硝酸盐废水的处理问题日益突出,对生态环境与人类健康造成了严重的威胁.电催化硝酸盐还原制备氨是一种在温和条件下去除硝酸盐污染物并生成氨的可行策略,兼具环境与经济双重价值.然而,由于硝酸盐还原制氨过程涉及复杂的电子质子转移过程,在低浓度(≤100 ppm)硝酸盐条件下,硝酸盐转化率低和氨产率不足严重制约了该技术的工业应用和发展潜力.因此,开发新型的可精准调控催化中心结构的催化剂材料,并通过调控催化剂表面对含N中间体的吸附来提高硝酸盐的转化率和氨的产率,对于解决上述问题具有重要意义.本文通过过渡金属离子M^(2+)(M=Fe,Co,Ni和Cu)与1,2,4,5-苯四胺(BTA)配体配位合成了四种一维共轭配位聚合物链(1D CCPs)材料,并将其应用于电催化硝酸盐还原制备高附加值产物氨.通过改变金属离子,电催化硝酸盐还原的选择性和活性得到了提高,这些1D CCPs结构为探索电催化硝酸盐还原制氨中的结构-活性关系提供了良好的平台.反应2 h后,Cu-BTA的产氨速率达到2.28 mg h^(-1)c^(-2),该结果是已报道的低浓度硝酸盐还原产氨的较高水平,在4h内硝酸盐的转化率达到96.74%,氨的选择性为79.46%.在经过25次循环实验后,催化性能依然保持良好.密度泛函理论计算结果表明,富电子Cu中心减弱了*NO中间体π轨道向Cu的d轨道的电子转移效率,并增强了Cu d_(yz)轨道对*NO的π轨道的电子反馈作用,提升了*NO中间体的自由能,N=O键被削弱,降低了NO→*NHO的ΔG值,进一步促进了氢化反应,提高了产氨速率.此外,Cu-BTA对氨的吸附能最小,有利于活性中心表面产生的氨快速脱除,加快了吸附-催化转化-脱附循环的速率,并且降低了催化中心中毒的可能性,从而实现了高催化活性和长期稳定性.综上,由于电催化硝酸盐还原制氨过程涉及八电子九质子转移过程,因此催化剂对不同含N中间体的适度吸附能力对保证高选择性,至关重要.本研究通过中心金属离子替换调控对N中间体的吸附,构建了可靠的电催化硝酸盐还原制氨的结构-活性关系,为电催化硝酸盐转化提供了新见解.